National Teams

Autism Speaks Inc.

In consideration for the opportunity to participate or volunteer my time or services in the Autism Speaks' Walk event (the "Event"), I, the below named Participant, agree to the following Participant Release and COVID-19 Attestation and Waiver of Liability (the "Release and Waiver of Liability") for myself and for my child (ren) who participate and/or attend with me:

Section 1. Participant Release

1. I hereby waive and release, for myself, my child, my heirs, executors and administrators, any and all rights, claims, liabilities and causes of action whatsoever I or my child may have against Autism Speaks Inc., its affiliates and Event operators, property owners, and sponsors and each of their respective parents, officers, directors, employees and agents (the "Event Parties") relating to or arising from my or my child's participation in the Event, including but not limited to personal injury.
2. I recognize the Event has inherent risk of injury and I hereby assume that risk on behalf of me and my child. If I or my child causes injury to any person or damage to any property while participating in the event, I hereby indemnify and hold harmless the Event Parties from and against any and all claims, suits, actions, losses, damages and expenses related to or arising from such injury or damage. It is further agreed that this waiver, release, and assumption of risk is to be binding on my heirs and assigns.
3. I agree to indemnify and to hold harmless the Event Parties free and harmless from any loss, liability, damage, cost or expense which they may incur as the result of my death or any injury or property damage that I may sustain while participating in said activity, or travel to the event at the venue or such other location as is selected.
4. THE PARTICIPANT further expressly agrees that the foregoing release, waiver, and indemnity agreement is to be as broad and inclusive as is permitted by the law of the State of New Jersey and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
5. THE PARTICIPANT HAS READ AND VOLUNTARILY SIGNED THE 'SIGNATURE PAGE' THAT ACCOMPANIES THIS RELEASE AND WAIVER OF LIABILITY, and further agrees that no oral representation, statement or inducement apart from the foregoing written agreement has been made.
6. I hereby give my consent to Autism Speaks Inc. and its affiliates to use my and my child's name and photographs, video and film ("Photos") of me and/or my child taken before, during or after the Event, in advertising and promotional materials to Autism Speaks, including but not limited to the Internet without compensation. I agree that no advertising or other material need be submitted to me or my child for approval. I agree that all photos of me and/or my child used by Autism Speaks Inc. and its affiliates are owned by Autism Speaks Inc. and they may copyright material containing the same. I hereby release, discharge, and agree to save harmless the Event Parties from any liability, including, without limitation, any claims for libel or invasion of publicity/private, by virtue of any use of my or my child's name and/or photos, including any alteration of such photos, whether intentional or otherwise. I have read and understand this Release and Waiver and declare all the information is truthful and accurate.

Section 2. COVID-19 ATTESTATION AND WAIVER OF LIABILITY

I, the below named Participant, acknowledge that the novel Coronavirus/COVID-19 is understood to be extremely contagious and is spread through person-to-person contact. Those infected may spread the disease without showing symptoms, and infection it can cause serious and potentially life-threatening illness and even death. While Autism Speaks has put in place preventative measures consistent with local regulations and CDC guidance to reduce the spread of Coronavirus/COVID-19, I acknowledge that Autism Speaks Inc. cannot guarantee that I will not become infected with the Coronavirus/Covid-19 and understand that I risk becoming exposed to and/or infected by the disease as a result of my participation in the Event, through the actions, omissions, or negligence of myself or Autism Speaks, its directors, associates, employees or agents including, but not limited to, Event Volunteers, workers or planners.

By signing this Release and Waiver of Liability, I attest that:

• I am not experiencing any symptoms of illness such as dry cough, difficulty in breathing, fever, fatigue, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell, or exhibiting any other symptoms of relating to Covid-19 or any communicable disease within the last 14 days.
• Neither I, nor any members of my household have experienced any of the above symptoms in the last 14 days.
• Neither I, nor members of my household have traveled by sea or by air, internationally within the last 14 days.
• I do not believe I, or members of my household have been exposed to anyone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
• I have not been diagnosed with Coronavirus/Covid-19 within the last 14 days.
• I am following all CDC recommended guidelines as much as possible to limit my exposure.

I understand that should any of the above change I shall notify Autism Speaks immediately and will not be permitted to participate in the Event.

I agree to not hold Autism Speaks Inc., its volunteers, members, officers, independent contractors, affiliates, employees, successors, and assigns (collectively the "Event Parties") liable for any exposure to the Coronavirus/COVID-19 caused by misrepresentation of the above attestation by other Event Parties, volunteers, or other participants.

Following the pronouncements above I hereby declare the following:

I am fully and personally responsible for my own health and actions while and during my participation in the Event and I recognize that I may be in any case be at risk for contracting Coronavirus/Covid-19.

I release and agree to hold the Event Parties harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for any damage or loss, bodily injury, illness, medical treatment, or death, that may be caused by any act, or failure to act by Autism Speaks Inc. or that may otherwise arise in any way in connection with the Event, including exposure or harm due to Coronavirus/COVID-19.

I agree that this Release and Wavier of Liability shall be governed by and construed in accordance with the laws of the State of New Jersey, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of the Release and Wavier of Liability as a whole.

I have read and understand this entire Release and Waiver of Liability, and declare all the information is truthful and accurate.

By clicking submit below, I have read and understand this entire Release and Waiver of Liability, and declare all the information is truthful and accurate.

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• Autism Speaks staff and volunteers will be required to wear masks at set-up and on Walk day.
• Vendors and sponsors are encouraged to wear masks at set-up and on Walk day
• Participants will be asked to wear masks if required by state and/or local regulations.
• Per CDC recommendations, unvaccinated participants are encouraged to wear masks at the event.